LASIK and surface ablation in corneal dystrophies

Woreta, Fasika A.; Davis, Gavin W.; Bower, Kraig S.

doi:10.1016/j.survophthal.2014.08.003

Cited by 22 publications

(34 citation statements)

References 69 publications

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“…[ 8 9 ] LKP or PKP were performed before the availability of the excimer laser. [ 10 11 ] Since the recurrences are superficial,[ 12 13 ] a retreatment with an excimer laser is possible avoiding the complications of PKP. [ 11 14 15 ] The aim of this study is to assess the clinical and visual outcomes after performing PTK in eyes that had prior grafts.…”

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confidence: 99%

Phototherapeutic keratectomy for recurrent granular dystrophy in postpenetrating keratoplasty eyes

Rathi

Taneja

Murthy

et al. 2016

Indian J Ophthalmol

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Purpose:The purpose is to assess the clinical and visual outcome after phototherapeutic keratectomy (PTK) procedure in eyes with prior penetrating keratoplasty (PKP) for granular corneal dystrophy (GCD) and the time of performance of repeat PTK for recurrence.Methods:PTK was performed for visually significant recurrence: A reduction in best-corrected visual acuity (BCVA) by >2 lines over BCVA before recurrence was considered as visually significant recurrence. Three eyes had amniotic membrane patch performed with PTK. The main outcome measures were a recurrence of GCD, clinical course, and visual outcome. Intervals between repeat PTK procedures were noted.Results:Six patients (n = 10 eyes; males: 4, mean age 39 ± 13.97 years) underwent PTK. The mean pachymetry before first PTK was 527.1 ± 34 microns. The mean duration between PKP and first PTK was 85.1 months (range: 37–108 months). Two and three PTK procedures were done for seven and five eyes, respectively. Mean duration between first and second and second and third PTK was 62.12 ± 34.41 and 42.8 ± 13.54 months respectively. The average cut depth was 43.66 ± 19.57, 75 ± 43.30 and 39 ± 19.79 microns after the first, second and third PTK procedures, respectively. All eyes had a corneal haze. Prefirst PTK mean BCVA was 20/200 and improved significantly after the first two PTK procedures to 20/40 and after the third PTK procedure to 20/32 (P < 0.001). Five eyes had hyperopia. One acute graft rejection was managed successfully at 5 months with medical therapy.Conclusion:Multiple PTK procedures can be performed safely with improved visual acuity in grafts without compromising graft survival.

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confidence: 99%

Phototherapeutic keratectomy for recurrent granular dystrophy in postpenetrating keratoplasty eyes

Rathi

Taneja

Murthy

et al. 2016

Indian J Ophthalmol

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“…Considering the correlation between GCD types and treatment options, and cases of post-LASIK GCD exacerbation, performing gene tests before refractive surgeries or PTK is critical 11–13 .…”

Section: Discussionmentioning

confidence: 99%

TGFBI Gene Mutation Analysis of Clinically Diagnosed Granular Corneal Dystrophy Patients Prior to PTK: A Pilot Study from Eastern China

Zeng

Zhao

Chen

et al. 2017

Sci Rep

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This study investigated the TGFBI gene mutation types in outpatients clinically diagnosed with granular corneal dystrophy (GCD) prior to phototherapeutic keratectomy (PTK), also calculated the mutation rate of subjects with normal corneas, but positive family history. Clinical GCD outpatients and consanguineous family members were enrolled in this study. Among total 42 subjects: 24 patients from 23 unrelated families had typical signs of GCD on corneas; 5 patients from 5 unrelated families had atypical signs; 13 subjects from 11 unrelated families had no corneal signs but positive family history. Using Avellino gene test kit, the TGFBI mutation detection was performed on DNA samples from all subjects. 36 subjects were detected to carry heterozygous TGFBI gene mutations. Among 24 clinical GCD patients, the proportion of R124H, R555Q, R124L, R555W and R124C were 37.5%, 16.7%, 25.0%, 20.8% and 0%, respectively, and 2 patients had been diagnosed with GCD according to the opacities thriving after LASIK (R124H) and PRK (R555W). The mutation rate of 13 subjects having no signs but positive family history was 69.2%. R124H mutation is the most prominent mutation type among GCD outpatients in Eastern China. It is recommended to conduct gene detection for patients with positive family history prior to refractive surgeries.

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“…There are also implications for patients with TGFBI dystrophies if they undergo LASIK. 31 Following photorefractive keratectomy (PRK) and LASIK surgery, an increase in stromal deposits and loss of visual acuity has been reported in several GCD2 patients carrying the TGFBI p.(R124H) mutation. Histology showed increased TGFBI hyaline deposits, particularly at the margin of the LASIK flap and in the stromal interface.…”

Section: Discussionmentioning

confidence: 99%

Genotype-Phenotype Correlation forTGFBICorneal Dystrophies Identifies p.(G623D) as a Novel Cause of Epithelial Basement Membrane Dystrophy

Evans

Davidson

Carnt

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The majority of anterior corneal dystrophies are caused by dominant mutations in TGFBI (transforming growth factor b-induced) collectively known as the epithelial-stromal TGFBI dystrophies. Most cases of epithelial basement membrane dystrophy (EBMD) are thought to result from a degenerative (nongenetic) process; however, a minority of cases are associated with specific TGFBI mutations. We evaluated the spectrum of TGFBI mutations and associated phenotypes in a United Kingdom cohort with typical epithelial-stromal TGFBI dystrophies and an EBMD cohort. METHODS.We recruited 68 probands with a clinical diagnosis of epithelial-stromal TGFBI dystrophy and 23 probands with bilateral EBMD. DNA was extracted from peripheral leukocytes, and TGFBI was bi-directly Sanger sequenced.RESULTS. Nine TGFBI mutations were identified. The most common occurred at the mutation hot-spot residues R124 and R555 in 61 probands; these individuals had a genotypephenotype correlation consistent with prior reports. Four probands with lattice corneal dystrophy carried a mutation in exon 14: p.(A620D), p.(V625D), and p.(H626R). We identified a p.(G623D) mutation in five probands, including two probands from the EBMD cohort. These subjects typically had an onset of severe recurrent corneal epithelial erosion in the fourth decade with mild diffuse or geographic subepithelial corneal opacities and only small anterior stromal lattice structures in older individuals. Symptoms of painful epithelial erosion improved markedly following phototherapeutic keratectomy.CONCLUSIONS. There was a strong correlation between genotype and phenotype for the majority of TGFBI mutations. In this cohort, the p.(G623D) mutation caused a greater proportion of TGFBI-associated disease than anticipated, associated with variable phenotypes including individuals diagnosed with EBMD.

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LASIK and surface ablation in corneal dystrophies

Cited by 22 publications

References 69 publications

Phototherapeutic keratectomy for recurrent granular dystrophy in postpenetrating keratoplasty eyes

Phototherapeutic keratectomy for recurrent granular dystrophy in postpenetrating keratoplasty eyes

TGFBI Gene Mutation Analysis of Clinically Diagnosed Granular Corneal Dystrophy Patients Prior to PTK: A Pilot Study from Eastern China

Genotype-Phenotype Correlation forTGFBICorneal Dystrophies Identifies p.(G623D) as a Novel Cause of Epithelial Basement Membrane Dystrophy

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